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NUR 325 > NUR 325 Exam #2 > Flashcards

NUR 325 Exam #2 Flashcards

(92 cards)

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1
Q

What is glucose regulation?

A

the process of maintaining optimal blood glucose

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2
Q

euglycemia (definition & levels)

A

normal blood sugar levels

70-140 mg/dL

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3
Q

hyperglycemia (definition & levels)

A

high blood sugar levels

> 100 mg/dL fasting
140 mg/dL regular
180 mg/dL severe

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4
Q

hypoglycemia (definition & levels)

A

low blood sugar levels

< 70 mg/dL regular
< 50 mg/dL severe

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5
Q

S/S of hypoglycemia

A

-reduced cognition
-tremors
-diaphoresis
-weakness
-hunger
-headache
-irritability
-seizures

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6
Q

S/S of hyperglycemia

A

-polyuria (overproduction of urine)
-polydipsia (excessive thirst)
-dehydration
-fatigue
-fruity odor to breath
-kussmaul breathing (rapid, deep breathing)
-weight loss
-hunger
-poor wound healing

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7
Q

polyuria

A

overproduction of urine

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8
Q

polydipsia

A

excessive thirst

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9
Q

possible causes of hypoglycemia

A

-result of insufficient nutritional intake
-adverse reaction to medications
-excess exercise
-underlying disease

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10
Q

possible causes of hyperglycemia

A

-result of insufficient insulin production/secretion
-excessive counter regulatory hormone secretion
-deficient hormone signaling

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11
Q

hypoglycemia mental status

A

anxious, irritability, confusion, seizures, unconsciousness, coma

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12
Q

hyperglycemia mental status

A

can range from alert to confused and coma

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13
Q

hypogylcemia skin

A

diaphoresis, cool, clammy

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14
Q

hyperglycemia skin

A

warm, moist

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15
Q

hypoglycemia respiratory

A

no change in respirations

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16
Q

hyperglycemia respiratory

A

deep, rapid respirations

fruity, acetone scent to breath

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17
Q

hypoglycemia cardiac

A

tachycardia

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18
Q

hyperglycemia cardiac

A

tachycardia if dehydrated

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19
Q

are ketones present in hypo or hyperglycemia?

A

hyperglycemia

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20
Q

What is the A1C (aka HbA1c) test?

A

blood test that measures the average blood sugar levels over the past 3 months

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21
Q

What does a higher A1C mean?

A

greater risk for developing type 2 diabetes

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22
Q

A1C values

A

-Normal A1C: below 5.7%
-Pre-diabetes: 5.7% - 6.4%
-Diabetes: > 6.5%

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23
Q

long-term consequences of hypoglycemia

A

-repeated hypoglycemic episodes lowers the threshold that stimulated counter regulatory hormone
-death

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24
Q

long-term consequences of hyperglycemia

A

-organ disease due to microvascular damage
-retinopathy
-neuropathy
-macrovascular angiopathy
-hypertension

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25
retinopathy
damage to blood vessels in retina causes blindness and blurred vision
26
neuropathy
peripheral nerve damage to the brain and spinal cord causes weakness, numbness, pain in hands and feet
27
macrovascular angiopathy
macrovascular = large vessels like arteries and veins angiopathy = disease of the blood vessels
28
glucose regulation- diet
-low in saturated fats -consistency in amount of food consumed -regular meal times -include omega 3 and fiber in diet to lower cholesterol
29
glucose regulation- exercise
physical activity lat least 3x a week = 150 minutes
30
Prevention/early recognition of type 2 DM
-screen pts with BMI over 25 -A1C test
31
pt & nursing interventions for hypoglycemia
-glucose tabs -glucagon for unconscious patients -eat full meals -15/15 rule
32
what is the 15/15 rule?
eat 15g of carbs then check BG after 15 minutes
33
pt & nursing interventions for hyperglycemia
-oral hypoglycemic agents -insulin -change in lifestyle -change in diet -weight control -education for self management
34
what are electrolytes?
minerals in the body that conduct electricity
35
What are the 4 minerals in the body?
potassium, sodium, calcium, magnesium
36
electrolyte function
-balancing water in the body -balancing pH level -moving waste out of body cells -moving nutrients into body cells -helping muscle/heart/nerve/brain function
37
what 2 groups are at high risk for impaired fluid and electrolyte balance?
infants and elderly
38
why are infants at the highest risk for fluid and electrolyte imbalance?
-high metabolic rate -immature kidneys -more rapid RR -proportionately greater body surface area
39
why are elderly at risk for impaired fluid and electrolyte balance?
-thirst sensation blunt -kidneys less able to respond to ADH -impaired ability to conserve
40
Risk factors for fluid and electrolyte imbalance
-vomiting -diarrhea -organ failure (liver, kidney, heart) -unexplained nausea -fatigue -dizziness -shortness of breath -muscle cramping -edema -sudden changes in weight
41
primary prevention - fluid and electrolyte imbalance
-pt teaching -dietary measures -fluid management
42
secondary prevention - fluid and electrolyte imbalance
-screening for imbalances -water replacement therapy -electrolyte supplements -pharmacology (diuretics, insulin, vasopressin- ADH) -daily weight -monitoring I/Os
43
diffusion
-movement of solutes (electrolytes) from an area of high concentration to low concentration -passive
44
osmosis
-movement of water across a semi-permeable membrane from an area of low concentration to an area of high concentration -active
45
oral hypoglycemics vs insulin administration
-oral hypoglycemics are administered when pt DOES have function pancreas -insulin is administered when client DOES NOT have functioning pancreas
46
why are oral anti-diabetics not used for type 1 diabetes?
-oral anti-diabetic meds require a functioning pancreas, which type 1 diabetics do not have
47
Why should patients with kidney failure, alcoholism, heart failure, or COPD not take metformin?
it can cause lactic acidosis in blood which can cause sepsis
48
When should regular insulin be administered? Why?
It should be administered 30 minutes before mealtime to ensure the client will ingest some carbs for insulin to act on --> reduces risk of hypoglycemia
49
How should the nurse administer insulins?
-alternate injection sites -regular insulin before NPH -second nurse check -understand sliding scales
50
_____ insulin before ____ insulin
regular before NPH
51
When insulin reaches it's ____ is when pt is most at risk for ________
peak, hypoglycemia
52
insulin pumps are for which kind of insulin?
short acting
53
What electrolyte imbalance may be caused/corrected by insulin? why?
hypokalemia, due to uptake of potassium from blood glucose
54
Lispro insulin info
-Onset: 15-30 minutes -Peak: 30 min - 3 hours -Duration: 3-5 hours -"meal-time" insulin -subQ
55
What kind of insulin is lispro?
rapid acting
56
Humulin R (_____) insulin
regular
57
What type of insulin is Humulin R?
short acting
58
Humulin R info
-Onset: 30 minutes- 1 hour -Peak: 1-5 hours -Duration: 6-10 hours -SubQ
59
NPH Insulin aka ____ ____
Humulin N
60
What type of insulin is NPH Insulin?
intermediate acting
61
NPH insulin info
-Onset: 1-2 hours -Peak: 4-14 hours -Duration: 14-24 hours -SubQ
62
Glargine Insulin brand name
Lantus
63
What type of insulin is glargine insulin?
long acting
64
Lantus generic name
glargine insulin
65
glargine insulin info
-onset: 1-4hr -peak: none/steady -duration: 24hrs -SubQ injection
66
hypertonic solution
-higher osmolality than blood -draws water OUT of cells into ECF, cell = shrinks
67
What should you monitor when giving a hypertonic solution?
BP, lung sounds, sodium levels
68
Examples of hypertonic solutions
-3% saline -D10W (10% dextrose in water) -D5NS (5% dextrose in normal saline, 0.9%) -D51/2NS (5% dextrose in half normal saline, 0.45% NS)
69
hypotonic solution
-lower osmolality than blood -moves water from ECF to ICF
70
what should you monitor when giving hypotonic fluids?
changes in mentation
71
examples of hypotonic fluids
-0.45% saline -0.33% saline -0.225% saline -D5W (starts as isotonic but becomes hypotonic in body due to body metabolizing dextrose)
72
isotonic fluids
-no movement between ECF and ICF
73
examples of isotonic fluids
-NS, 0.9% saline -LR (Lactated ringers) -D5W, starts isotonic but becomes hypotonic in body)
74
What's in lactated ringers?
sodium, potassium, chloride, calcium, lactate
75
what do lactated ringers do?
-expands ECF -treats burns and GI losses -contraindicated with liver dysfunction, hyperkalemia, and hypovolemia (isotonic)
76
Intracellular fluid (ICF)
fluid within cells, 2/3
77
extracellular fluid (ECF)
fluid outside of cells, 1/3 contains interstitial fluid and intravascular fluid
78
interstitial fluid
fluid around the cells
79
sodium function
-supports the function of nerves and muscles -helps maintain BP -regulates body's fluid balance
80
potassium function
-helps with nerve and muscle cell function, especially muscles in the HEART
81
What category does the medication Glipizide fall under?
sulfonylurea
82
What category does the medication Repaglinide fall under?
meglitinide
83
What category does the medication metformin fall under?
biguanide
84
What category does the medication prioglitazone fall under?
thiazolidinedoines
85
hypovolemia
too little fluid (ECV deficit)
86
causes of hypovolemia
-polyuria -prolonged vomiting -prolonged diarrhea -sweating -dehydration
87
symptoms of hypovolemia
-sudden weight loss -skin tenting -dry mucous membranes -vascular underload --> rapid thready pulse, postural BP drop, HR increase, lightheadedness, flat neck veins when supine, syncope (fainting), shock
88
what is the best treatment for hypovolemia?
isotonic fluids
89
hypervolemia
too much fluid, ECV excess
90
hypervolemia symptoms
-sudden weight gain -edema -vascular overload --> bounding pulse, distended neck when upright, dyspnea (difficulty breathing), pulmonary edema
91
hypervolemia pt teaching
-reduce salt in diet -monitor weight -monitor fluids
92
interventions for hypervolemia
-diuretic -reduce fluid intake -reduce salt in diet -dialysis if severe

NUR 325 (3 decks)

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